ACEP 13: Improving Discharge Instruction Recall

The Particulars: Previous studies indicate that patient understanding of ED discharge instructions is limited. Other studies have shown that the teach-back method—asking patients in a non-shaming manner to repeat in their own words what they need to know—can improve understanding of these instructions among inpatients. Use of this method in the ED setting has not been well described.

Data Breakdown: ED patients participating in a study were given standard discharge instructions or instructions using the teach-back method. All participants were called between 6 and 30 hours post-discharge and asked about their discharge instructions. The average recall rate was 82.1% in the teach-back group, compared with a 68.9% rate that was observed in the standard group. Completely accurate responses in four domains among the two groups were as follows:

Teach-Back Group

Standard Group

Diagnosis

78.1%

49.0%

Medication reconciliation

68.4%

52.9%

When to follow up

75.2%

61.5%

Signs or symptoms to return to the ED

49.5%

22.1%

Take Home Pearl: The teach-back method appears to improve recall of discharge instructions among ED patients.